Interesting Physician Perspective On NPs - page 10

by PMFB-RN

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I am not an NP. I am a full time rapid response nurse at a teaching hospital. This morning I stopped in to residents office to update the night residents on what had happened with their patients and what I had done. They were in... Read More


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    Besides the states, the scope of practice of NP,s/PA's is likely also influenced by politics and the employer. I worked for a while as a staff nurse on a busy detox floor in a NY hospital. The hospital did not employ NP,s, only PA's.. On my unit, the PA,s wrote all the orders. They worked from detox protocols which they modified and they also treated concurrent medical conditions. There was an attending. He would come to the unit and sit in the nurses station for brief periods of time, one /day during the week and on weekends there was a moonlighter who did the same thing..I think the PA's called the attending sometimes... There was a range of competence with the PA's..the good ones were excellent...the not so good ones listened to the nurses!! The attending had three units.. He may have signed charts but I don't think he ever saw patients..
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    This is a little off topic for where the thread has gone most recently, but back to the original idea, there is a pecking order for MDs/DOs too (actually don't all MDs pretty much think they are better than all DOs?) and between specialties, I have heard many a FP physician lament the lack of respect/pay they receive.

    I think this NP vs PA thing is ridiculous. My husband is a PA, and wonderful at his job. I am amazed at the breadth of his knowledge and his comfort working in a rural ER without a physician readily at hand (only available by telephone). Although I am supposed to be more independent, I wouldn't feel comfortable in his role, although there are probably plenty of NPs that would. My state gives NPs and PAs equally limited rights to practice and in fact the NP role is not legislatively defined and some physician advocacy groups in the state have suggested that NPs are practicing completely illegally even when bound up with all the regulations, collaborative practice agreements, etc.

    As others said earlier on this thread, I don't think tearing down and belittling the PA profession builds us up in any way.

    And to the previous poster who disseminated false information earlier, the Army PA program is a Masters program and has been for at least 6 years.
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    Quote from treejay
    Not accurate, in 2 ways:

    1) NPs do not need a doctorate, nor is there any timeframe which says they will need one. I'm quite surprised regarding the misunderstanding RNs and others here have regarding this topic. It was recommended that by 2015 Master's training programs start to offer DNP. But there is absolutely no requirement. Amazing how people are continually confused by this

    2) True, you can enter PA school with any degree, but most enter with a science degree. And here's why. The prerequisite list is very heavy! Heavier than medical school in many cases. Keep in mind, you can also enter medical school with any degree. Here is the prereq list from my PA school:
    Human anatomy* 4 Biochemistry
    Human physiology* 4 Cellular biology
    Genetics 3 Human sexuality
    Psychology 3 Immunology
    General chemistry* 8 Medical terminology
    Organic chemistry* 4 Pharmacology
    Microbiology* 4 Spanish
    College algebra or higher 3 Statistics




    Let us strive for accuracy when making comments. We would only expect the same when taking care of patients.
    I took all these classes for my BSN (except immunology) and they were required before applying for my NP program. So the education is similar.
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    It's incredible how anecdotal this whole thread is, with opinions on all sides by lots of folks that aren't NP's or PA's.

    Anyone that has had a few years of nursing under their belt will tell you stories about great NP's and PA's that they've worked with who loved their jobs, and they will also tell you about NP's or PA's that weren't that good or they hated their job.

    The fact is, outside of a quarter of the states in this country, where NP's essentially operate like General Practice physicians, PA's and NP's work in a very similar roll, and any professional advancement done on a state level by either group needs to be with the help of the other. While many of us might understand the differences between the two professions, a huge chunk of politicians don't and group us together when drafting laws. It's up to all of us to advocate for each other as we all do important work in the field.
    myelin, on eagles wings, and SmoothJams like this.
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    I know this thread is a little dead but I wanted to add a coment re: the South, cost of living, and low salaries.

    AZ and NM are both indy practice states with equally low, if not lower (esp. AZ) cost of living than the SE. Also high salaries.

    Sad, because I love the south and would love to live there but as a future PMHNP hopeful, I've just completely crossed it off my radar.
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    Quote from blondielocks
    I know this thread is a little dead but I wanted to add a coment re: the South, cost of living, and low salaries.

    AZ and NM are both indy practice states with equally low, if not lower (esp. AZ) cost of living than the SE. Also high salaries.

    Sad, because I love the south and would love to live there but as a future PMHNP hopeful, I've just completely crossed it off my radar.

    That's a shame...we're looking to expand my practice, and if Alabama was to your taste, that might have been a great fit!
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    Haven't read through the whole thread since I last commented, has anyone ever argued that perhaps 4 years undergrad (generally unrelated to health care), 4 years med school, and 4 - 5 years post doctoral training might make someone over qualified for primary care? I mean I know we are a narsasistic society and think that we need the best but would you demand a masters level engineer to fix your car?
    blondielocks likes this.


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